Colorectal Cancer Screening for Average‐Risk Adults

Publication Date: May 1, 2018
Last Updated: March 14, 2022


The ACS recommends that adults aged 45 years and older with an average risk of colorectal cancer undergo regular screening with either a high‐sensitivity stool‐based test or a structural (visual) examination, depending on patient preference and test availability. As a part of the screening process, all positive results on noncolonoscopy screening tests should be followed up with timely colonoscopy.
  • begin screening at age 45 years
  • regular screening in adults aged 50 years and older

When to Stop CRC Screening

The ACS recommends that average‐risk adults in good health who have a life expectancy of greater than 10 years continue colorectal cancer screening through the age of 75 years. (Qualified)
The ACS recommends that clinicians individualize screening decisions for individuals aged 76 through 85 years, based on patient preferences, life expectancy, health status, and prior screening history. (Qualified)
The ACS recommends that clinicians discourage individuals over age 85 years from continuing screening. (Qualified)

Recommendation Grading



Colorectal Cancer Screening for Average‐Risk Adults

Authoring Organization

Publication Month/Year

May 1, 2018

Last Updated Month/Year

January 22, 2024

Document Type


External Publication Status


Country of Publication


Document Objectives

This guideline is intended to provide guidance to adults at average risk of CRC, to clinicians who counsel and refer patients to CRC screening, and to health care systems to support best practices in the early detection and prevention of CRC. 

Target Patient Population

Patients with risk of colorectal cancer

Inclusion Criteria

Female, Male, Adult, Older adult

Health Care Settings

Ambulatory, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant


Assessment and screening, Diagnosis

Diseases/Conditions (MeSH)

D015179 - Colorectal Neoplasms, D003107 - Colorectal Surgery, D011315 - Preventive Medicine, D000076862 - Diagnostic Screening Programs


colorectal, colorectal cancer, colorectal neoplasm, preventive care